Elizabeth Nyblade, Ph.D.
Gateway Centre
1313 E. Maple Street
Bellingham, WA 98225
 
P: 360.647.8295
 
 
Why Trump Won't Give Up the Verbal Abuse
Donald Trump is many things. . . businessman, entertainer and politician. But did you know that he is a verbal abuser?
read more...
The Verbal Abuse of Donald Trump

The presumptive Republican Candidate for President is a verbal abuser. Donald Trump has called his political opponents names like “hypocrite,” “weak,” “a pathetic figure,” “liar,” “choker.” And he relishes repeating nasty nicknames for his opponents: “Crooked Hillary,” “Lying Ted,” “Low-energy Jeb.”

I have seen and treated many targets of verbal abuse over my last forty years as a practicing psychologist. With Donald Trump as a candidate, we can all see the cycle of abuse playing out on the national stage.

read more...
Part III: How to Take an Adult Timeout
The abuser is in a timeout from you when you can no longer hear, see or pay attention to the abuser. Your goal is to take a timeout as rapidly and as consistently as possible when your partner says something that is verbally or emotionally abusive.
read more...
 
Have a question or comment?
Fields marked * are required
Name*
Email*
Question / Comment
Access Code
Please Enter the Access Code *
  
 
   
Considering Seeing a Counselor? Start Here!
01/04/2013

If you’re considering seeing a counselor, you’re not alone. Every year millions of Americans seek counseling and many others think about it but decide not to go. I’d like to answer some of your first questions about the process of counseling, the content of counseling, and some of the logistics of counseling.

If you haven’t considered attending counseling before, or if you’ve had an unsatisfactory experience, then this article may provide you with new information. If you’ve tried counseling before and it met your needs, then you may be optimistic, but still concerned about going to a new therapist, or going to your previous therapist with a new issue. This booklet can help you get organized for that next encounter.

Every year I see hundreds of people who have never talked to a counselor before. Many of them report that they have mixed emotions about counseling, and thought long and hard before they decided to come. They may have negative thoughts like these:
  • I don’t know anyone who has been to counseling. I don’t know what to think about it.
  • My doctor suggested I go into counseling and I was sure he thought I was crazy.
  • My doctor recommended counseling. I thought she meant that I didn’t really have anything wrong with me, that it was all in my head.
  • If I were strong enough, I wouldn’t need counseling. Going to a counselor means you’re weak.
  • I thought about all the jokes and cartoons about “shrinks” and the people who see them and I didn’t want to get involved.
  • I’m afraid everyone will find out about my problems. I don’t want to be seen in a counselor’s office. Maybe I should wear a mask?

These are all normal thoughts, and not surprising if you haven’t tried mental health counseling before. It may help to think of counseling as hiring a professional to help you, just as you hire an auto mechanic or hairstylist to help you. You’re doing the hiring, and you can fire the helper if you’re not satisfied with the service. And you should, if the service isn’t meeting your needs. You’re not telling a counselor that she will be your boss and you’re not planning to throw yourself off a cliff while hoping the counselor will save you.

You’re still in charge of your life, with or without a counselor. You already hire people to give you advice about your car and your body. Maybe you also have a priest, minister, or rabbi whom you consult about your soul.

A counselor is someone who has studied information about the relationship of mind and body. A counselor should be able to teach you how to improve your relationship with yourself, your family and friends, and your community. The process of counseling can give you:
  • New experiences and new perspectives about what’s happening to your body and mind.
  • Information about yourself and about problems you may have
  • Practice at changing the behaviors that affect your health and happiness.
  • Relief from suffering and support for your work to maintain your health.

Why does my doctor want me to get counseling?

Psychotherapy (or talk therapy, or counseling) is one of the best-researched treatments known to medicine. In a scientific review of 457 studies on the success of psychotherapy, conducted in 1980 by Consumer Reports ™,


Smith et al reported that, “psychotherapy benefits people of all ages as reliably as schooling educates them, medicine cures them, or business turns a profit.”

Of course, not everyone gets educated by going to school, and not all businesses make a profit. But counseling, even when it is very short, is good for your physical and mental health. Just as your physician might refer you to a surgeon or a dermatologist for specialty treatment, your physician would refer you for counseling because it’s good for what ails you. Counseling is a treatment that helps most people, most of the time, achieve their physical and mental goals, and your physician wants you to get those benefits.

Is talking to a counselor any different than talking to a friend?

Yes, it is.

Talking to a friend should be a positive experience. You probably “vent” to a friend when something stressful happens to you, or ask for advice if you don’t know what to do. You expect your friend to support you with positive comments and if they have expertise in some area, for example car repair or knitting, you probably expect good advice when you ask for it. You expect to return the favor and pay your friend back by listening, supporting and advising your friend equally in other areas or at other times. Talking to friends and family, and having friends and family to talk to, is one of the most important predictors of happiness. People who don’t have a good support network of friends and family are usually less healthy, less happy, and less stable when life throws them a curve.

On the other hand, talking to a friend or family member has some limitations:
  • If you’re going through a particularly bad time, for example going through a divorce, you may find that you only want to talk about your problems and your negative feelings. Your friends and family may start to avoid you because you “bring them down.” No friend is able to listen to negative things forever without having their own negative feelings about what you’re talking about.
  • Friends or family members probably have an angle, an idea of what they think you ought to do or how you ought to proceed. For example, if you separate from your partner, maybe they think you should go back if they like your partner, or if they don’t like her, maybe they think you ought to leave. Either way, they’re not going to be objective or neutral and they won’t pay as much attention to your thoughts on the matter. Friends and family may also be impatient and just wish you’d “make up your mind” and get it over with instead of encouraging you to take the time you need to consider everything that’s on your mind.
  • Whatever your issue is, you may be too embarrassed to talk to friends and family about it. You may not have friends that would appreciate you asking questions about your sexuality, for example, or you may not want your friends to know about some things in your past that you think would change the way they look at you.
  • You may have tried talking to friends and family and been disappointed by the way they repeated things you said to them that you considered private. Not everyone is able to keep secrets because most people find it helpful to talk about things that bother them. What you say to your friend may bother your friend, and be difficult for your friend to live with just as it was for you to live with.
  • And you probably want more than advice and a listening shoulder, even if you don’t realize it. You’d probably like to learn from the experience of going through a hard time so you’re less likely to have that hard time occur to you again, or so that you cope with it better the next time. It’s one thing to survive a trauma. We all do that! But we’d all like to learn from it and thrive and gain the skills it takes to become a better person with more resilience in the future. To get that sort of a learning experience, you probably would do best with a professional teacher, and that’s what a counselor is.

I have real physical problems. How could talking to a counselor help with those?

The mind and body are intimately connected. You live through events and have thoughts and feelings that constantly affect your body in positive and negative ways. We even talk about our feelings in a physical way. We shake with fear, get a dry mouth from stage fright, blush with shame and get a sinking feeling in our stomach from guilt. We say that difficult encounters with people give us a headache.

Our body comes complete with an emergency response system, the Autonomic Nervous System. When we think something is dangerous our body prepares for “fight, flight or freeze.” We aren’t born knowing what is dangerous, however. We rely on our brain, our thoughts, to tell us what and where the danger is. Even though we aren’t really expecting our boss to physically strike us, our brain tell us that when the boss is angry, we are in danger, so our bodies make preparations like tensing muscles, drying our mouth, stopping our digestive processes. All of those are real physical reactions to a real danger.

Our emergency response system is wonderfully efficient, and hard to fool. You can tell yourself you aren’t nervous about an upcoming job interview, but you will probably have a dry mouth anyway, no matter what you say to yourself. In fact, not paying attention to your nervousness makes the physical problems worse. You may tell yourself you’re calm, cool and collected about an upcoming stressful event, but your emergency response system may still be ringing all the alarm bells. And because you don’t think you should be nervous or upset, you won’t act in ways to reduce your stress because you think you shouldn’t be having it in the first place! It’s hard to fix something when you don’t think it’s broken.

But our bodies are really built for sudden emergencies that disappear very rapidly – like the appearance of a saber-toothed cat ahead of us that we can outrun. The emergency response is built in, but calming ourselves down after the danger has passed isn’t automatic. And what if the danger never passes? What if the boss is always angry, or always angry at you, or what if the boss is unpredictable and inconsistent? And it’s worse if you learned as a child that an angry parent meant a hurtful parent.

And that’s why talk therapy can help with physical problems. Our thoughts, feelings and experiences, can cause physical problems, or make them worse. If you blush when someone tells a dirty joke, you know you’ve had a physical reaction to a mental event. If there were some reason that blushing was bad for your body and it got worse over time, you might want to learn not to have a blushing reaction. There would be two ways to go about this. (1) You could learn to consider talking or joking about sex not embarrassing, and that’s exactly the sort of learning you do in talk therapy, or (2) you could learn not to have a face-flushing reaction when you’re embarrassed, and that’s also possible in talk therapy by some mind-body methods like relaxation or biofeedback.

Let’s assume you had a shoulder injury in a car crash. You have real pain from that injury, and it doesn’t seem to go away over time. How can talk therapy help with pain? Counseling helps in those same two ways. (1) You can learn to focus on the things that are stressful and bother you, and work through them mentally so you solve the unsolved issues that are causing you to tense up and make your pain worse and (2) you can reduce the pain directly by learning to relax, including even relaxing the shoulder when you’re in pain. Either or both of these methods can reduce your very real physical pain. Most people underestimate how big an effect the mind has on the body in every day life. Pain isn’t ‘all in your head’ but your head can certainly do a big job of managing it. 

Is all counseling the same?

No, because all counselors are different.

There is such a thing as a good counselor. Probably most counselors are good at what they do. But you’re not just looking for a good counselor. You’re looking for a good counselor for you. You want a good fit with a counselor, and that has to do with two things, what the counselor is like and what you are like.
  • Some counselors are very supportive and empathetic and show that to their patients or clients. Others are more aloof and “professional”.
  • Some counselors are more judgmental than other counselors about issues that are controversial in the culture – like abortion or homosexuality or child-rearing. They may be more inclined to share their personal feelings or judgments about these issues.
  • Some counselors are more knowledgeable than others about biological issues – like pain or head injury. Or they may know more about a specialty area like eating disorders or sexual enrichment counseling. Not all counselors are expert in all things.
  • Some ‘counselors’ are not actually experts at counseling. They may be experts at prescribing medications, or psychological testing, or doing biofeedback for stress management. A psychiatrist may be trained to prescribe medications, for example, but may not be as good at helping his or her patients learn to adjust to difficult circumstances or recover from past traumatic events as a social worker. And someone who’s an expert at diagnosing difficulties to present to the court may not be as skilled at treating those difficulties.
  • Some counselors are very structured and like to set goals formally, give you homework to work on, and take an active part in helping you work toward your goals. These counselors may give you advice and instruction. They may provide written handouts, and recommend books to you. Other counselors are more informal, and respond each week to what you bring in, leaving you to set the agenda and expecting that you are working in the best way to get your needs met as long as you are returning for the next session. They may reflect back your own thoughts more, and insert themselves and their opinions less into the counseling session.
  • You probably can’t judge how good counselors are by the degree they hold. Psychiatrists are the most expensive of the mental health professionals, but research says that they aren’t necessarily better at counseling than psychologists, social workers or mental health counselors. 

What happens in counseling?

Generally, you’ll fill out information about yourself first, as you would for any doctor, and you’ll receive information about the counselor. Hopefully you will learn about her employment history and some information about how she was trained and what problems she likes to work with. If you’ve ‘interviewed’ the counselor by phone first, you’ll probably have a good start on that already.

In the first session, your counselor will ask you to talk about the issue that brings you in to counseling, and you’ll describe that in your own words. You’ll probably discuss it in detail with the counselor and you’ll get a chance to see how the counselor thinks about things, and how she works with you. Probably you’ll also be asked some standard background questions about your schooling, your medical history, your family and your current circumstances. You’ll probably talk about what your goals are for counseling, that is, what you want to change about yourself and about your life. Often the goals will take the form of new skills you want to learn. For example, you may want to be able to handle your mother better when she visits you, or you may want to learn to understand your past better.

After the first session, you’ll probably want to talk about events from the previous week that relate to your goals or thoughts and feelings you’ve had that you want to talk over and understand better. You may want advice about how to handle specific issues in your daily life or you may want support for the progress you’ve made in achieving your goals. You won’t necessarily ‘feel good’ after each session, but you should ‘feel good about the session.’ You should feel that you were heard, that the counselor was on your side and wanted you to achieve your goals. You should think that the counselor was knowledgeable about your problem and that she was contributing to you solving it during the session. The counselor might point out things you already knew or share his or her own thoughts. Above all, you should feel hope that you can achieve your goals, if not today, at a foreseeable time in the future.

Therapy ends when you decide you’ve achieved your goals. Or perhaps when you decide you’ve benefited as much from talking to this counselor as you’re likely to. If you have big ambitions and smaller resources, maybe therapy ends when your reimbursement for therapy from your insurance runs out. For some people, therapy lasts for years and involves major changes in their life circumstances or in their ways of dealing with issues. For other people, therapy lasts just a few sessions until the specific issue they talk about has been resolved.

Some people see a therapist only once and leave because they didn’t think it helped them. Oddly enough, the research says that those people were helped by that single contact even though they didn’t think it was helpful!

How can I get the most out of counseling?

Counseling is a process of learning, so the same methods that would help you get the most out of a class will help you get the most out of counseling.
  1. Work at remembering what goes on during the therapy session.

    Bring a notepad and take notes on what the counselor says. Some counselors will print specific notes out from their computer, or they will have a handout with the information to give you.

    Most counselors will allow you to record the therapy session. Ask first and then bring in a recording device so you don’t need to stop a session to take notes. Just remember not to leave incriminating tapes around your house.

    After the therapy session, write down the things you learned that you think were most important for you. Reread your notes, or play the tape during the week between sessions to remind you of things you’d like to think about.

  2. Do homework or exercises between sessions to help you learn more.

    If you’re working on being more outgoing, decide on a small step you can take in that direction between therapy sessions. For example, decide that you’re going to introduce yourself to one stranger every day this week at work. Take notes on what your goal was, how you worked on it, and what barriers you couldn’t overcome that week and want to talk about.

    Ask your therapist to help you plan homework or exercises between sessions. The therapist doesn’t think like you, so she will probably come up with something you didn’t think of yourself. Make sure the homework or exercise isn’t too big a step for you to take all at once.

    Maybe there’s a book you can read about the issue or a biography of a person who overcame this handicap. Maybe there’s a self-help book or a book of programmed instruction that you can use between sessions to increase your learning. Ask the therapist what books she recommends for you. Check the library or look up second-hand books online to keep the cost affordable.

  3. Keep a journal or diary of your experiences.

    A personal journal is a major help to you when you’re trying to increase your learning. Pick a time that is good for you, relax over a cup of tea or a glass of wine and just write about yourself and the thoughts and feelings running through your head. What happened in your day and how did you feel about it? What did that event remind you of in your past or how did it worry you about your future?

Thinking About the Future

Hopefully you’ll have a positive experience in counseling and reach your goals with the first counselor you choose. If you are dissatisfied with the experience, remember that you may have hired, and then fired, an auto mechanic for not meeting your needs, but you probably didn’t decide that no auto mechanics could fix your car just because that one didn’t. Not all counselors are alike and not all counselors will be a good fit for you. If you don’t feel you’re getting your needs met by this counselor, try a different one.

No counselor will make your troubles go away or make you happy, but that isn’t their job. It’s the counselor’s job to show you ways to lighten your troubles and to show you ways you can make yourself happy. And you must locate a counselor who can do that job for you.

If you were content with the counseling experience, that’s wonderful! You may want to see the same counselor again in the future if you come up with a similar issue, or you may want to return to counseling to finish up on other issues that have come up. If you haven’t been functioning well in lots of areas in your daily life, you may want to continue counseling when you can to work on those issues that keep recurring. 

And remember to hold on to hope for the future! You can change your thoughts, feelings and behaviors. You can’t change the past, but you don’t need to. If you learn to understand your past better, and learn to react differently to events that remind you of your past, you are making all the changes you need to make to have a satisfactory experience with counseling and to cope better with your present and future.

And take with you my best wishes for a satisfying learning experience in counseling!


Related Articles:
  • How to Interview (and Review) a Therapist so You can get the Right 'Match'. (01/18/2013)
    Finding the right therapist calls for work and thought and it is more likely that you'll find what you're looking for from recommendations from trusted friends, family and professionals like your doctor. Once the recommendations have been collected, Dr. Nyblade discusses how to interview and review your therapist to get the right fit.
Back   
Search Articles:   
  

MindingYourSpiritTogether.com is the professional home of Elizabeth Nyblade, Ph.D.
Gateway Centre • 1313 E. Maple Street • Bellingham, WA 98225

Telephone: 360-647-8295

Fax: 360.647.8296

Copyright © 2013 - 2016. All rights reserved.

Website design and created by Net Solutions